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Association of preoperative psychopharmacological treatment and the risk of new chronic opioid use after hip and knee arthroplasty: a Danish registry-based cohort study of 73,033 procedures: a Danish registry-based cohort study of 73,033 procedures

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Title: Association of preoperative psychopharmacological treatment and the risk of new chronic opioid use after hip and knee arthroplasty: a Danish registry-based cohort study of 73,033 procedures: a Danish registry-based cohort study of 73,033 procedures
Authors: Simon Kornvig, Henrik Kehlet, Christoffer C Jørgensen, Anders Fink-Jensen, Poul Videbech, Alma B Pedersen, Claus Varnum
Source: Acta Orthop
Acta Orthopaedica, Vol 96 (2025)
Kornvig, S, Kehlet, H, Jørgensen, C C, Fink-Jensen, A, Videbech, P, Pedersen, A B & Varnum, C 2025, 'Association of preoperative psychopharmacological treatment and the risk of new chronic opioid use after hip and knee arthroplasty : a Danish registry-based cohort study of 73,033 procedures', Acta Orthopaedica, vol. 96, pp. 492-498. https://doi.org/10.2340/17453674.2025.44228
Publisher Information: MJS Publishing, Medical Journals Sweden AB, 2025.
Publication Year: 2025
Subject Terms: Male, Opioid-Related Disorders/epidemiology, Osteoarthrosis, Orthopedic surgery, Analgesics, Opioid/therapeutic use, Hip, Pain, Postoperative/drug therapy, Arthroplasty, Replacement, Knee/adverse effects, Middle Aged, Preoperative Care/methods, Denmark/epidemiology, Psychotropic Drugs/therapeutic use, Article, Arthroplasty, Cohort Studies, Arthroplasty, Replacement, Hip/adverse effects, Risk Factors, Humans, Female, Knee, Registries, RD701-811, Aged
Description: Background and purpose: Chronic opioid use is of great concern worldwide. Thus, identification of risk factors for new chronic opioid use (COU) after hip and knee arthroplasty is imperative to target preventive strategies. Depression/anxiety may be risk factors for new COU. However, no studies have investigated whether any or subgroups of preoperative psychopharmacological treatments (PPTs) are risk factors for new COU after hip and knee arthroplasty in a nationwide setting, which was the aim of the present study.Methods: This population-based cohort study included 40,476 primary hip and 32,557 primary knee arthroplasties from 2015 to 2022 using the Danish Hip/Knee Arthroplasty Registers. Preoperative opioid users were excluded. Dispensing records of psychotropics and opioids were obtained from the Danish National Prescription Registry. Relative risks of new COU were estimated with 95% confidence intervals (CI) using binary regression and adjusted for age, sex, and Charlson Comorbidity Index.Results: Among hip patients using psychopharmacological treatments (PPTs), 4.6% (202/4,439) had new COU compared with 2.2% (788/36,037) of patients not using PPTs, corresponding to an adjusted relative risk of 1.8 (CI 1.6–2.1). Among total and unicompartmental knee arthroplasties, 9.1% (298/3,261) and 6.4% (59/926) had new COU compared with 4.7 (1,011/21,529) and 2.9% (201/6,841) of patients not using PPTs, corresponding to adjusted relative risks of 1.8 (CI 1.6–2.1) and 2.0 (CI 1.5–2.7), respectively. Analyses of PPT subgroups showed similar results.Conclusion: Hip and knee arthroplasty patients using PPTs have almost a twofold increased risk of new COU. This emphasizes the need for prevention strategies in these patients.
Document Type: Article
Other literature type
ISSN: 1745-3682
1745-3674
DOI: 10.2340/17453674.2025.44228
Access URL: https://doaj.org/article/7bc303a918da4c4f8c383babce7f0daf
Rights: CC BY
URL: http://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/)
Accession Number: edsair.doi.dedup.....f05351884d4cfed230d196df23d7e9c8
Database: OpenAIRE
Description
Abstract:Background and purpose: Chronic opioid use is of great concern worldwide. Thus, identification of risk factors for new chronic opioid use (COU) after hip and knee arthroplasty is imperative to target preventive strategies. Depression/anxiety may be risk factors for new COU. However, no studies have investigated whether any or subgroups of preoperative psychopharmacological treatments (PPTs) are risk factors for new COU after hip and knee arthroplasty in a nationwide setting, which was the aim of the present study.Methods: This population-based cohort study included 40,476 primary hip and 32,557 primary knee arthroplasties from 2015 to 2022 using the Danish Hip/Knee Arthroplasty Registers. Preoperative opioid users were excluded. Dispensing records of psychotropics and opioids were obtained from the Danish National Prescription Registry. Relative risks of new COU were estimated with 95% confidence intervals (CI) using binary regression and adjusted for age, sex, and Charlson Comorbidity Index.Results: Among hip patients using psychopharmacological treatments (PPTs), 4.6% (202/4,439) had new COU compared with 2.2% (788/36,037) of patients not using PPTs, corresponding to an adjusted relative risk of 1.8 (CI 1.6–2.1). Among total and unicompartmental knee arthroplasties, 9.1% (298/3,261) and 6.4% (59/926) had new COU compared with 4.7 (1,011/21,529) and 2.9% (201/6,841) of patients not using PPTs, corresponding to adjusted relative risks of 1.8 (CI 1.6–2.1) and 2.0 (CI 1.5–2.7), respectively. Analyses of PPT subgroups showed similar results.Conclusion: Hip and knee arthroplasty patients using PPTs have almost a twofold increased risk of new COU. This emphasizes the need for prevention strategies in these patients.
ISSN:17453682
17453674
DOI:10.2340/17453674.2025.44228